Korobelnik J F, Hannouche D, D'Hermies F, Egot S, Frau E, Chauvaud D, Thanh H X
Department of Ophthalmology, Bichat-Claude Bernard Hospital, Paris, France.
Retina. 1998;18(3):228-32. doi: 10.1097/00006982-199803000-00006.
Silicone oil must be removed from the eye to avoid late complications after the surgical management of proliferative vitreoretinopathy (PVR). Macular pucker, frequently observed after retinal detachment surgery, is responsible for visual impairment. The safety of a procedure combining epimacular membrane peeling and silicone oil removal was retrospectively evaluated.
Fourteen eyes that had previously undergone vitrectomy and silicone oil tamponade for rhegmatogenous retinal detachment with severe PVR, penetrating or blunt trauma, and intraocular foreign bodies were included. Silicone oil tamponade was maintained for a mean period of 30 weeks (range, 12-108 weeks). The removal of silicone oil was combined with the peeling of an epimacular membrane.
Mean follow-up after silicone oil removal was 86 weeks (range, 13-234 weeks). The final retinal reattachment rate was 78%. Macular pucker recurred in one eye after a 24-month period. Best-corrected visual acuity improved two lines or more in eight eyes (57%) and reached 20/200 or better in eight eyes (57%) at last follow-up.
Macular pucker dissection and silicone oil removal can be safely combined. This single procedure can obviate the need for further surgery in eyes that have already undergone multiple operations and allows good visual recovery.
为避免增生性玻璃体视网膜病变（PVR）手术治疗后的晚期并发症，必须从眼内取出硅油。黄斑皱襞在视网膜脱离手术后经常出现，是导致视力损害的原因。本研究对黄斑前膜剥除联合硅油取出术的安全性进行了回顾性评估。
纳入14只眼，这些眼之前因严重PVR、穿透性或钝性外伤以及眼内异物行玻璃体切除术及硅油填充治疗。硅油填充平均持续30周（范围12 - 108周）。硅油取出与黄斑前膜剥除同时进行。
硅油取出后的平均随访时间为86周（范围13 - 234周）。最终视网膜复位率为78%。一只眼在24个月后黄斑皱襞复发。末次随访时，8只眼（57%）最佳矫正视力提高两行或更多，8只眼（57%）最佳矫正视力达到20/200或更好。
黄斑皱襞剥离与硅油取出可安全联合进行。这一单一手术可避免对已经接受多次手术的眼进行进一步手术，并能实现良好的视力恢复。
